Esophageal carcinoma especially in our country is still a cause of mortality and morbidity. Pulmonary complications in patients who undergo esophagectomy are common. There are not good tools and sure ways to predict these complications. Unfortunately pulmonary complications’ rate is high.
Since March 1998 to February 2007 200 patients (150 male and 50 female) underwent Esophagectomy due to esophageal carcinoma in thoracic surgery ward. We assessed and analyzed all data that had correlation between pulmonary complications and patients risk factors. Complications include the length of hospitalization, mechanical ventilation, morbidity and mortality. Patients’ risk factors include age, preoperative chemo-radiotherapy, stage of the disease and preoperative spirometry.
we studied 200 patients, from March 1998 to February 2007. We grouped our patients into three categories:1-Normal (FEV1 ≥ 80% predicted) 2-Mildly impaired (FEV1 65% to 79% predicted)3-More severely impaired (FEV1 < 65% predicted)Although almost all patients had radiographic pulmonary abnormalities, significant pulmonary complications occurred in 40 patients (20%) which underwent Esophagectomy. Pleural effusion and atelectasia in 160 patients (80%). 24 patients needed chest-tube insertion in addition to those placed at the time of operation. Pneumonia was the most common. Clinically important pulmonary complications occurring in 60 cases (30%). 20 patients (10%) developed ADRS. 14 patients (7%) developed chylothorax. 10% of patients died. 30 patients (15%) required mechanical ventilation.
Esophageal resection is associated with high rated pulmonary complications. We reviewed a number of preoperative clinical variables to determine whether they contributed to postoperative pulmonary complications as well as other outcomes. In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS). In fact pulmonary complications rate after Esophagectomy are high and there was associated mortality and morbidity.
In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS). So assessment of these criteria before operation is very important.
Abulfazal Shirin Zadeh, No Financial Disclosure Information; No Product/Research Disclosure Information